Serum procalcitonin for differential diagnosis of acute exacerbation and bacterial pneumonia in patients with interstitial lung disease

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Abstract

Background: Acute exacerbation and bacterial pneumonia are major life-threatening conditions in patients with interstitial lung disease (ILD). The rapid recognition of these 2 different conditions is important for their proper treatment. An elevated procalcitonin (PCT) level is commonly detected in patients with bacterial infections. This study assessed the usefulness of the serum PCT level as a biomarker for the differential diagnosis of acute exacerbation and bacterial pneumonia in patients with ILD. Materials and Methods: In this prospective observational study, we enrolled patients with ILD who had experienced recently progressive dyspnea and exhibited new infiltrations on chest radiographs. We classified these patients into an acute exacerbation group and a bacterial pneumonia group and compared their baseline characteristics and laboratory parameters, including the PCT level. Results: Of 21 patients with ILD, 9 patients had bacterial pneumonia. Both the groups showed similar baseline characteristics. The bacterial pneumonia group demonstrated a high PCT level. The PCT level in the acute exacerbation group was significantly lower than that in the bacterial pneumonia group (0.05 versus 0.91 ng/mL, respectively; P <0.001). Other parameters, such as the C-reactive protein level, leukocyte count and body temperature, were also lower in the acute exacerbation group. At a cutoff value of 0.1 ng/mL, the sensitivity, specificity and negative predictive values of the serum PCT level were 88.9%, 100.0% and 92.3%, respectively. Conclusions: These findings suggest that the serum PCT level is useful in the differential diagnosis of acute exacerbation and bacterial pneumonia in patients with ILD.

Original languageEnglish
Pages (from-to)499-505
Number of pages7
JournalAmerican Journal of the Medical Sciences
Volume351
Issue number5
DOIs
Publication statusPublished - 2016

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Bacterial Pneumonia
Interstitial Lung Diseases
Calcitonin
Differential Diagnosis
Serum
Body Temperature
Leukocyte Count
Bacterial Infections
Dyspnea
C-Reactive Protein
Observational Studies
Thorax
Biomarkers
Prospective Studies
Sensitivity and Specificity

Keywords

  • Bacterial
  • Interstitial
  • Lung diseases
  • Pneumonia
  • Procalcitonin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{1c890438554c4440bc6b6b856e8497dc,
title = "Serum procalcitonin for differential diagnosis of acute exacerbation and bacterial pneumonia in patients with interstitial lung disease",
abstract = "Background: Acute exacerbation and bacterial pneumonia are major life-threatening conditions in patients with interstitial lung disease (ILD). The rapid recognition of these 2 different conditions is important for their proper treatment. An elevated procalcitonin (PCT) level is commonly detected in patients with bacterial infections. This study assessed the usefulness of the serum PCT level as a biomarker for the differential diagnosis of acute exacerbation and bacterial pneumonia in patients with ILD. Materials and Methods: In this prospective observational study, we enrolled patients with ILD who had experienced recently progressive dyspnea and exhibited new infiltrations on chest radiographs. We classified these patients into an acute exacerbation group and a bacterial pneumonia group and compared their baseline characteristics and laboratory parameters, including the PCT level. Results: Of 21 patients with ILD, 9 patients had bacterial pneumonia. Both the groups showed similar baseline characteristics. The bacterial pneumonia group demonstrated a high PCT level. The PCT level in the acute exacerbation group was significantly lower than that in the bacterial pneumonia group (0.05 versus 0.91 ng/mL, respectively; P <0.001). Other parameters, such as the C-reactive protein level, leukocyte count and body temperature, were also lower in the acute exacerbation group. At a cutoff value of 0.1 ng/mL, the sensitivity, specificity and negative predictive values of the serum PCT level were 88.9{\%}, 100.0{\%} and 92.3{\%}, respectively. Conclusions: These findings suggest that the serum PCT level is useful in the differential diagnosis of acute exacerbation and bacterial pneumonia in patients with ILD.",
keywords = "Bacterial, Interstitial, Lung diseases, Pneumonia, Procalcitonin",
author = "Sim, {Jae Kyeom} and Oh, {Jee Youn} and Lee, {Eun Joo} and Hur, {Gyu Young} and Lee, {Seung Heon} and Lee, {Sung Yong} and Lee, {Sang Yeub} and Kim, {Je Hyeong} and Chol Shin and Shim, {Jae Jeong} and In, {Kwang Ho} and Kang, {Kyung Ho} and Kyung-Hoon Min",
year = "2016",
doi = "10.1016/j.amjms.2016.02.029",
language = "English",
volume = "351",
pages = "499--505",
journal = "American Journal of the Medical Sciences",
issn = "0002-9629",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Serum procalcitonin for differential diagnosis of acute exacerbation and bacterial pneumonia in patients with interstitial lung disease

AU - Sim, Jae Kyeom

AU - Oh, Jee Youn

AU - Lee, Eun Joo

AU - Hur, Gyu Young

AU - Lee, Seung Heon

AU - Lee, Sung Yong

AU - Lee, Sang Yeub

AU - Kim, Je Hyeong

AU - Shin, Chol

AU - Shim, Jae Jeong

AU - In, Kwang Ho

AU - Kang, Kyung Ho

AU - Min, Kyung-Hoon

PY - 2016

Y1 - 2016

N2 - Background: Acute exacerbation and bacterial pneumonia are major life-threatening conditions in patients with interstitial lung disease (ILD). The rapid recognition of these 2 different conditions is important for their proper treatment. An elevated procalcitonin (PCT) level is commonly detected in patients with bacterial infections. This study assessed the usefulness of the serum PCT level as a biomarker for the differential diagnosis of acute exacerbation and bacterial pneumonia in patients with ILD. Materials and Methods: In this prospective observational study, we enrolled patients with ILD who had experienced recently progressive dyspnea and exhibited new infiltrations on chest radiographs. We classified these patients into an acute exacerbation group and a bacterial pneumonia group and compared their baseline characteristics and laboratory parameters, including the PCT level. Results: Of 21 patients with ILD, 9 patients had bacterial pneumonia. Both the groups showed similar baseline characteristics. The bacterial pneumonia group demonstrated a high PCT level. The PCT level in the acute exacerbation group was significantly lower than that in the bacterial pneumonia group (0.05 versus 0.91 ng/mL, respectively; P <0.001). Other parameters, such as the C-reactive protein level, leukocyte count and body temperature, were also lower in the acute exacerbation group. At a cutoff value of 0.1 ng/mL, the sensitivity, specificity and negative predictive values of the serum PCT level were 88.9%, 100.0% and 92.3%, respectively. Conclusions: These findings suggest that the serum PCT level is useful in the differential diagnosis of acute exacerbation and bacterial pneumonia in patients with ILD.

AB - Background: Acute exacerbation and bacterial pneumonia are major life-threatening conditions in patients with interstitial lung disease (ILD). The rapid recognition of these 2 different conditions is important for their proper treatment. An elevated procalcitonin (PCT) level is commonly detected in patients with bacterial infections. This study assessed the usefulness of the serum PCT level as a biomarker for the differential diagnosis of acute exacerbation and bacterial pneumonia in patients with ILD. Materials and Methods: In this prospective observational study, we enrolled patients with ILD who had experienced recently progressive dyspnea and exhibited new infiltrations on chest radiographs. We classified these patients into an acute exacerbation group and a bacterial pneumonia group and compared their baseline characteristics and laboratory parameters, including the PCT level. Results: Of 21 patients with ILD, 9 patients had bacterial pneumonia. Both the groups showed similar baseline characteristics. The bacterial pneumonia group demonstrated a high PCT level. The PCT level in the acute exacerbation group was significantly lower than that in the bacterial pneumonia group (0.05 versus 0.91 ng/mL, respectively; P <0.001). Other parameters, such as the C-reactive protein level, leukocyte count and body temperature, were also lower in the acute exacerbation group. At a cutoff value of 0.1 ng/mL, the sensitivity, specificity and negative predictive values of the serum PCT level were 88.9%, 100.0% and 92.3%, respectively. Conclusions: These findings suggest that the serum PCT level is useful in the differential diagnosis of acute exacerbation and bacterial pneumonia in patients with ILD.

KW - Bacterial

KW - Interstitial

KW - Lung diseases

KW - Pneumonia

KW - Procalcitonin

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U2 - 10.1016/j.amjms.2016.02.029

DO - 10.1016/j.amjms.2016.02.029

M3 - Article

C2 - 27140709

AN - SCOPUS:84971014040

VL - 351

SP - 499

EP - 505

JO - American Journal of the Medical Sciences

JF - American Journal of the Medical Sciences

SN - 0002-9629

IS - 5

ER -